Pdf accidentes de trafico_2010_isabel [comprimido]

ASSISTING ACCIDENT VICTIMS: BASIC COMMUNICATION TECHNIQUES IN ROAD TRAFFIC INJURIES

ACCIDENTES DE TRÁFICO: EMERGENCIAS,
REANIMACIÓN Y TRANSPORTE SANITARIO

Mª ISABEL HERRANDO RODRIGO
herrando@unizar.es

ASSISTING ACCIDENT VICTIMS: BASIC COMMUNICATION TECHNIQUES
IN ROAD TRAFFIC INJURIES
Departamento de Filología Inglesa y Alemana

22 Enero de 2010
Universidad de Zaragoza

Accidentes de tráfico: Emergencias, Reanimación y Transporte sanitario 1


Table of contents

• Introduction: Aims and Communicative Foundations
• Primary or Basic Exploration SVB: Adult Basic Life
Support vs. Advanced Life Support
• Further Exploration
• Procedures
• References



Table of contents

• Introduction: Aims and Communicative Foundations
• Introduction Aims
To establish effective communication with traffic injuries.
To dominate a useful sytematic communicative
conventions which give us confidence with traffic injuries:
using English as a vehicle or lingua franca for handling
succesfully with these patients .

To be able to acquire basic techniques of spoken grammar:
Direct and clear chunks which will enable us to cope with
non-native speakers of Spanish in stressful situations.



1. Introduction

• Communicative Foundations
Look the patient in the eye (if possible).
Use your body language .
Repeat clear, simple and direct statements such as:



Useful language
• Calm down.
• Take it easy, I´m here with you.

• I´m here to help you. Don´t worry. We are the
emergency medical technicians.

• Please trust me and don´t move. Help us to help you.
• Don´t worry in a short while we will give you a painkiller
but we have to examine you carefully so please you
must cooperate.
• Please trust me, I´m here with you. We are here to help
you and we know what we have to do.



2.- Adult Basic Life Support

Is the patient severly injured or not severly injured?
We have to determine if the patient is conscious, if the
patient breaths and if he or she has pulse.
• Basic life support (BLS) is a level of medical care which is used
for patients with life-threatening illness or injury until the patient
can be given full medical care. It can be provided by trained
medical personnel, including emergency medical technicians, and
by laypersons who have received BLS training. BLS is generally
used in the pre-hospital setting, and can be provided without
medical equipment.
• Basic life support consists of a number of life-saving techniques
focused on the medicine "ABC"s of pre-hospital emergency care.



Adult Basic Life Support

• ABCs (Cardiopulmonary resuscitation)
Airway: the protection and maintenance of a clear passageway for
gases (principally oxygen and carbon dioxide) to pass between
the lungs and the outside of the body
Breathing: inflation and deflation of the lungs (respiration) via the
airway
Circulation: providing an adequate blood supply to the body,
especially critical organs, so as to deliver oxygen to all cells and
remove carbon dioxide. Circulation also includes the control of
potential hemorrhage.



Adult Advanced Life Support

ALS deals with several techniques addressed to deliver a
defenetely treatment to the patient. They consist of airways
management, proper breathing control, vascular access and drug
administration.
Besides, ALS concerns with the transport and overcoming of the
potential injuries relative to hypoxia/isquemia.



Enlace a página BLS:
http://hcd2.bupa.co.uk/fact_sheets/html/abcfirst.html

http://www.healthcarelearning.leeds.ac.uk/pages/learnzone/3_bls/bls_nav.htm



How can we dertemine Traumatic Head Injury?

Neurologic Exploration

1.- Pupils dilatation:
• In U.S. medical jargon, it's much more common to say that the
patient's pupils are equal, rather than isochoric. Normal pupils are
usually referred to by the achronym PERRL (pupils equal, round
and reactive to light). In Spanish, PERRL translates to "pupilas
isocoricas y normoreactivas a la luz (sometimes abbreviated
PINRAL)
• Dilated non-reactive pupils. Different dilatation; brain death,
potential donor.
• Pupilary reflex: light reflex; light reflex



How can we dertemine Traumatic Head Injury?

2.- Glasgow comma scale:

Better to:
Ocular response (1-4)
Verbal response (1-5)
Motor response (1-6)



3.- Further Exploration

Do you suffer from any allergy? ALLERGIC TO ANYTHING?

Have you ever suffered from a severe illness? HAD ANY
SERIOUS ILLNESS? ANY CURRENT ILLNESS?

Have you been operated on? ANY SERIOUS OPERATION?



Useful language
• Calm down.


must cooperate.



Further Exploration
• How badly hurt/injured the patient is:
What has happened? (What happened to you?)
What´s the matter with you? How do you feel?
Do you feel pain in YOUR joints or muscles?
Was your seatbelt fasten? (evaluating Thoracic pain).
When have you eaten or drunk for the last time? (evaluating the
possibility or vomitting) cough up (blood)
Have you had alcohol or drugs?
How many people travelled with you?
What does it hurt you the most?
Where do you feel pain? That it hurts you?



Head, neck, thorax, abdomen, upper/lower limbs

• HEAD (Let me examine you)
Have you hit your head?
If so, What part has been hit?
Do you feel any injury invisible to me?Conventionalized
structure based on moves.
Does it hurt when I press here? Does it hurt all the
time?
Have you got a headache?
Do you feel faint?



• HEAD
Commands:
• Open your mouth. Is there something that bothers you?
Any pain or injury?
• Open and close your eyes. Rise your eyebrows. Follow me
finger while I move it laterally.
• Stick out your tongue. Show me your teeth.
• With your eyes shut or close. Do you feel this?
Caress/prick.
CRANIAL PAIRS (NERVES)



• NECK
Where does it hurt?
Does it hurt when I touch you?
Undo the cervical collar while exploring the patient’s neck
without routing it.




• THORAX
Does your chest hurt?
Does it hurt if I press here?
Hurts when breathing? (Asymmetry/Dissymmetry observe if
an hemi thorax rises more than the other when breathing)




• ABDOMEN
Does your belly hurt?
Does it hurt when pressing? Observe if it is soft or hard
ACUTE ABDOMEN or hot belly/internal hemorrhoid.
Nauseas? Do you feel like vomiting?
Do you feel dizzy?
Do you have the feeling of having swallow blood?
Do you currently suffer from your stomach?
Any ulcer? Do you usually have stomach protectors?




• UPPER LIMBS
Observe; strength, mobility and sensibility.
Can you rise YOUR arm? Try to separate your arm from
your trunk .
Grasp softly my hand
Close your eyes. Do you feel this?
Do I touch you?
Am I caressing or pricking?
Observe paresthesias. PINS AND NEEDLES (hormigueo)




• LOWER LIMBS
Observe; strength, mobility and sensibility.
Can you rise YOUR leg? Try to separate your arm from your
floor .
Close your eyes. Do you feel this?
Do I touch you?
Am I caressing or pricking?
Observe paresthesias. PINS AND NEEDLES (hormigueo)



Useful language
• Calm down.


must cooperate.



4.- Procedures
• Let me examine you. The pronoun WE is preferred to I, this
use of the pronoun projects the idea of a collective decision.
A decision taken by a technicians team.
• We´re going to undo your clothes. We are going to have
them cut
• I´m going to use some stickers in order to check your heart,
ok?
• We´ll give you an injection. [We´re going to give you a shot
(coll injection or pick)]
• We’re going to take your blood pressure, we’re going to tire
this around your arm. You will feel a slight pressure.



Procedures
• We are going to use this mask and these tubes to improve
your breathing. Don’t worry is just oxygen.
• Now I’m gong to pick your finger to measure and control
your blood-sugar level.
• Is it cold? How cold freezing/chilling?
• We are going to TAKE YOUR TEMPERATURE using this
gadget in your ear.
• We are tiring a rubber band (Elastic band Br.E) around your
arm. You will feel a needle stick, it may hurt, it’s under
control.
• We’re going to use a vein puncture because we need to use
a dropper (vein dropper)



Procedures
• This gadget will tell us how your breathing is going, do not
worry it does not hurt
• We are going to clean your injuries. Does it hurt?
• You don’t have allergies, do you?
• My colleagues are going to take you to hospital by
helicopter. It´s better because is faster



5.- References and Aknowledgements
• Useful online medical publications:
Docguide
HealthDay News
New York Times Health Guide
Medical News Today
Johns Hopkins News Release

• Webs used
http://www.englishmed.com/
http://www.medworm.com/
http://en.wikipedia.org/wiki/Emergency_medical_technician
http://esl.proz.com/
http://www.health.nsw.gov.au/mhcs/
http://www.clinicalanatomy.com/medicalterms.htm



References and Aknowledgements
• Sources for medical abbreviations:

http://www.medilexicon.com/medicalabbreviations.php

• Other sources:

Care for You – English for Health and Social Care by Ruth Flaß;
Bildungsverlag EINS Troisdorf 2006; 1. Auflage

English Elements; by Sue Morris and Ann Schmid; Hueber Verlag 2002

English in Medicine by Eric H. Glendinning and Beverly A. S. Holmström;
Cambridge University Press 1998; 2nd edition



References and Aknowledgements
I would like to thank your presence and attention here today.

I also owe my gratitude to Pedro Satústegui and J.A. Tobajas
for inviting me to participate with this seminar.

Thank you very much indeed.
If you ever need to contanct me, please write to:

herrando@unizar.es
(Isabel Herrando. Escuela Universitaria de Ciencias de la Salud)

Have a nice weekend!


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